Health conditions and residential concentration of poverty: A study in Rio de Janeiro, Brazil.

This study aimed to establish the geographical relation of health conditions to socioeconomic status in Rio de Janeiro, Brazil. All reported deaths in the municipality from 1987 to 1995 were considered. The 24 administrative regions that composed the city served as the geographical units. A geographical information system (GIS) was used to link mortality data and population census data and to establish the geographical pattern of the following health indicators: infant mortality rate, standardized mortality rate, life expectancy, and homicide rate. The GIS also provided data on the location of low-income communities. A varimax rotation principal component analysis combined information on socioeconomic conditions and provided a two-dimension basis to assess contextual variation. The 24 administrative regions were aggregated into three clusters and identified as relevant to reflect the socioeconomic variation. Almost all health indicator thematic maps showed the same socioeconomic stratification pattern. The worst health situation existed in the harbor area and northern vicinity, the sector with the highest concentration of slum residents. The best health situation was found in geographical units situated along the coast, the sector with the highest concentration of affluent residents. The western area, which also has poor living standards but a low concentration of slums, demonstrated intermediate health conditions. These findings suggested that social and organization characteristics of low-income families might have a significant role in understanding health variations. Health and other social programs targeting these communities are recommended.